Healthcare Provider Details
I. General information
NPI: 1952113888
Provider Name (Legal Business Name): OPEN BIONICS INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 01/27/2025
Last Update Date: 02/20/2025
Certification Date: 02/20/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
100 PARK AVE # 1664
NEW YORK NY
10017-5516
US
IV. Provider business mailing address
200 UNION BLVD STE 440
LAKEWOOD CO
80228-1812
US
V. Phone/Fax
- Phone: 877-437-6276
- Fax: 720-640-0405
- Phone: 720-417-8698
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 222Z00000X |
| Taxonomy | Orthotist |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 224P00000X |
| Taxonomy | Prosthetist |
| License Number | |
| License Number State | |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 335E00000X |
| Taxonomy | Prosthetic/Orthotic Supplier |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
DANIEL
D
GREEN
Title or Position: CLINIC MANAGER, CPO
Credential: CPO
Phone: 838-900-3924